%0 Journal Article
%T Improving adherence to medical regimens for juvenile rheumatoid arthritis
%A Michael A Rapoff
%A Carol B Lindsley
%J Pediatric Rheumatology
%D 2007
%I BioMed Central
%R 10.1186/1546-0096-5-10
%X Children and adolescents with juvenile rheumatoid arthritis (JRA) are often asked to adhere consistently and over a long period of time to a variety of medical regimens, most notably, medications and therapeutic exercises. We have chosen to use the term JRA because almost all of the studies in this area have been done with children meeting the American College of Rheumatology criteria for JRA [1]. Regimens for JRA may have delayed beneficial effects and in the short term may cause unwanted side-effects such as gastrointestinal irritation and pain. This constellation of factors associated with treatments for JRA (i.e., the need for consistent adherence over a long period of time, delayed beneficial effects, and negative side-effects) are predictive of greater adherence problems to medical regimens in pediatric chronic disease [2]. This purpose of this review will be to 1) describe current regimens, define adherence, and review the prevalence of nonadherence to regimens for JRA; 2) summarize and critically evaluate research on improving adherence to regimens for JRA; and 3) review strategies for enhancing adherence in clinical practice.Pediatric rheumatic disease encompasses chronic multi-system disorders that involve acute and chronic tissue inflammation of the musculoskeletal system, blood vessels, and skin. JRA is the most common form of chronic arthritis and a major cause of both short and long-term disability. Patients are often required to adhere to complex medical regimens and cope with pain and psychosocial aspects of their disease. The etiology of JRA is not known but genetic and environmental factors likely are important. The laboratory tests are rarely definitive, the disease evolves over time and the treatment response is often not predictable. Even with good disease control, symptoms may fluctuate with other factors, such as intercurrent infection and weather changes.Synovitis is the hallmark of the disease and there are three basic subtypes, defined by t
%U http://www.ped-rheum.com/content/5/1/10